Provider Demographics
NPI:1639188873
Name:TROMELLO, BONNI (CFNP)
Entity Type:Individual
Prefix:MRS
First Name:BONNI
Middle Name:
Last Name:TROMELLO
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:558 N VENTU PARK RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320-2718
Mailing Address - Country:US
Mailing Address - Phone:805-480-0499
Mailing Address - Fax:805-480-0866
Practice Address - Street 1:558 N VENTU PARK RD
Practice Address - Street 2:SUITE B
Practice Address - City:NEWBURY PARK
Practice Address - State:CA
Practice Address - Zip Code:91320-2718
Practice Address - Country:US
Practice Address - Phone:805-480-0499
Practice Address - Fax:805-480-0866
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANPF7530363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care